A sausage-like bump on each side of my face after a deep plane facelift that makes me unhappy?

Question

I had a deep plane facelift done 63 days ago. What can these sausage-like bumps be? They are soft. Its not swelling. (I have no swelling elsewhere) And they appear more when I speak. My surgeon is very skilled and says he wants to wait at least 6 month has passed. But in the meantime, could you please tell me what you think it is and if you think there is a way for my surgeon to remove them? I am very happy with everything but these bumps looks very strange and it makes me unhappy.

Gregory S. Keller, MD, FACS · Answer

There is a layer of fascia overlying the buccal fat pads that can be pierced.  The protrusion of the buccal fat through the deep fascia causes the type of bulge that you have.  If it is not recognized during surgery, and the rent in the fascia sutured, the usual solution is simply to remove the lump by taking out buccal fat through the mouth.  This has to be performed with care to avoid taking too much. You appear to be somewhat thin, so, it is possible that, at around the 6 month to one year point, the face flap may need to be opened and the buccal fat rotated upward or pushed inward and sutured to avoid a "joker" look.  Many surgeons are only now starting to perform deep plane surgery (though deep plane surgery started with Torg Skoog, a Swedish plastic surgeon), so we are seeing more of this situation presenting for revision surgery.

Andres Bustillo, MD, FACS · Answer

These areas may be the buccal fat pads. I agree with waiting 6 months until everything heals to consider doing something.

Evan Ransom, MD, FACS · Answer

Thank you for the question and the photos. Without an exam in person, and perhaps review of your operative notes, it is impossible to say exactly what this is. Some educated guesses would be: small hematoma that turned into scar tissue; fat that was either moved or placed in these areas; or a local tissue reaction to some deep suture material placed during your surgery. Please check in with your surgeon about the best next steps.

John Michael Thomassen, MD · Answer

It appears that your jowl region was lifted and now is causing fullness in your cheek area.  This can be treated with small cannula liposuction under local anesthesia.

Ravi Dahiya, MD · Answer

I would agree with the idea of waiting for now. Having said that I would agree with some other comments that suggest that this might be related to a repositioning of the buccal fat as a result of the deep plane nature of your lift. Certainly sometimes buccal fat removal is indicated but in other situations, quite the opposite can look better, namely fat grafting. We of course lose volume in the face as we age so sometimes these types of postop issues arise because of the lack of fat throughout the face. I would discuss both options with your surgeon once the appropriate amount of time has passed.

A sausage-like bump on each side of my face after a deep plane facelift that makes me unhappy?

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Answer: Jowls

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A sausage-like bump on each side of my face after a deep plane facelift that makes me unhappy?

Answers (8)

Answer: Jowls

Answer: Jowls

Answer: Deep plane facelift

Answer: Deep plane facelift

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Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.